SPUTUM CONVERSION RATES (SCRs) AMONG SMEAR POSITIVE PULMONARY TUBERCULOSIS PATIENTS ON ANTI-TB DRUG: ASSESSING THE NNAMDI AZIKIWE UNIVERSITY TEACHING HOSPITAL, NNEWI, NIGERIA.

Okonkwo, R. C., Ele, P.U., Anyabolu, A. E. , Ifeanyichukwu, M. O.*, Onwunzo, M. C., Chukwuka, C. P. and Enemuo, E.

ABSTRACT

Tuberculosis (TB) remains a major public health issue in Nigeria, which accounts for 5.6% of the overall global TB burden. Early case detection and effective treatment using the Directly Observed Treatment Short Course (DOTS) strategy are the adopted control programs. An operational indicator for the DOTS strategy is the sputum conversion rate (SCR) at the end of two months of intensive treatment. This study determined the association between treatment and SCR among patients attending the DOTS clinic of the Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria. A total of 215 sputum smear positive pulmonary TB patients enrolled for treatment at the TB DOTS clinic between January, 2012 and February, 2014 were recruited for this study. Of these, 180 patients who completed their intensive phase of treatment were reviewed by follow up sputum smear microscopy. Two consecutive early morning sputum samples were collected from each patient and examined microscopically to determine sputum conversion rate. The relationship between SCR and initial sputum grading between genders of patients were determined. The study recorded a sputum conversion ratio of 76.7% and SCR was seen to have a significant association with initial sputum grading. The lower sputum grading (scanty and 1+) had higher SCR (92.95% and 83.7% respectively) compared with the higher sputum grading (2+ and 3+) which had 71.4% and 72.1% SCRs respectively. The different age groups showed comparable SCR. The females had a higher SCR (78.6%) than the males (73.6%). It may be necessary to consider the relationship between SCR and initial sputum grading in determining the dosage and duration of therapy in the DOTS program.

Keywords: Tuberculosis, DOTS, SCR, Treatment.